醫學專欄~趙泰宏-冰凍(五十)肩

1. 疾病介紹
(primary adhesive capsulitis)
(frozen shoulder)
1934 Codman
1945 Neviaser
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2. LQÀDPPDWLRQ

3. (capsular contracture)
(adhesive capsulitis)
1993 (AAOS)
(global)
(osteopenia)
2% 5%
30% 40
60
20-30%
病因探討
( )
(humeral head)
(glenoid)
360 (synovial
ÀXLG

5. TGF-
1.
10% 20%
2.
3.
( )
疾病自然史
(self-limiting)
1987
Neviaser
1 4
freezing stage , Nevi-
aser stage 2
6 9
frozen stage , Nevi-
aser stage 3
4 6
thawing stage , Ne-
viaser stage 4
6 2
疾病診斷:

6. (dull or aching)
(global
LOM)
X
(MRI)
51%
15% 35%
MRI
疾病治療
3
90%
(manipulation)
1. (NSAID)
aspirin diclofenac
indomethacin
NSAID
2.
(3 6 )
3.

7. 4-6
(freezing stage)
1-2 1 3
(long term
outcome)
(anterior approach) (posterior
approach)
(posterior angle of acromion)
(coracoid process)
(lesser tuberosity of humerus)
40mg triamcinolone
lidocaine
(low or high
grade)
(stretching)
ROM(range of motion)
1. -
90
30
( 1)
2. -
15
( 2)
3.
30
( 3)
4.
10%
4
1. (suprascapular
nerve block SSNB) bupivacaine
triamcinolone blind

8. 2. (hydrodilation)
3. (MUA Manipu-
lation Under Anesthesia)
MUA
4. 1979
Conti
superior
glenohumeral ligament rotator interval
subscapularis tendon
MUA
MUA
3 4
恢復期
6 3
結論：
self-limited natural history

9. Hydrodilation and SSNB
MUA
1
2
3